The present invention relates generally to a dental cleaning device and more particularly to a device to clean the lingual surfaces of dental implant posts; the under surfaces of loaded prostheses on the implant posts; facial, distal, and mesial sides of the dental implant posts; and all exposed sides of a fixed partial denture or bridge.
It will be appreciated by those skilled in the art that osseointegrated dental implant systems have revolutionized the field of implantology. Implants are now routinely considered as an option in the treatment of partial and complete edentulism. Regardless of the implant system used, success is intrinsically dependent on the amount and quality of bone available at the implant site, the patient's health and cooperation, the design of the prosthesis, and ultimately the patient's ability to clean and maintain the implant post and prosthesis once in place.
Implants are surgically placed in a three-step procedure. First, surgical sites for the implant fixtures are selected, and the gingiva is incised and reflected back to expose the bone. Through a series of successively larger drills, a hole is prepared to receive the implant screw. Once in place, the screw is covered over with the gingiva and left in a healing stage for osseointegration to occur for approximately six months. The second stage entails the uncovering of the screws, placing abutment cylinders on the screws, and healing caps on top of the abutment cylinders. This stage heals for approximately four to six weeks. The third stage begins with the removal of the plastic healing caps and ends when the final prosthesis is screwed in place or loaded onto the abutment cylinders.
Dental implant posts (or abutments) and the prosthesis (or bridge) must be cleaned daily of plaque and food debris, or a process similar to periodontitis begins around the implant post, and the supporting bone is lost. This is also true of fixed partial dentures or true bridges which utilize teeth as their abutments.
Experience dictates that most all patients can clean the buccal or lip side and interproximal or right and left sides of the abutments adequately with a conventional toothbrush and periodontal aids. However, very few patients, if any, can adequately clean the lingual surfaces. The requirement for a toothbrush, which has the capability of cleaning all sides with relatively little complexity to the patient, becomes paramount.
The need for dental implants in the 1990's has been documented in recent government studies that indicated that there is a significant degree of edentulism (missing teeth) in the U.S. population. According to a 1985-1986 national survey of the oral health of the United States employed adults and senior citizens conducted by the National Institute of Dental Research, four percent of persons aged thirty-five to sixty-four years and forty-two percent of those over sixty-five years of age are totally endentulous. When this study was compared to a similar study conducted in 1971, the results of the comparison indicate that for the next few decades, there will be a significant number of individuals with compromised dentitions for whom implants may be indicated. With the heightened health consciousness of our society and the increased availability of dental health insurance plans, implants will become a reasonable alternative to removable prosthetic appliances. These implants provide an alternative that should enhance the quality of life during the senior years. It has been predicted that as many as 300,000 dental implants will be used on this population by the year 1992.
There are several types of implant systems available. These are classified according to their shape and position in the jaw. They include subperiosteal, transosteal, and endosseous implants. Each type of implant system must be cleaned to prevent failure of the system from bone loss caused by the same disease that causes tooth loss.
Patients with implants should be on a regular recall schedule to monitor the maintenance of the implant-supported prosthesis and their plaque control. Maintenance programs include radiographic evaluation, methods of plaque and calculus removal, and appropriate antimicrobial agents.
The average implant is approximately three-eighths to one-half inches tall. As a result, the neck of any periodontal aid should be capable of clearing the implant to reach the implant posts.
To date, patients have a variety of periodontal aids at their disposal to remove plaque from the abutments which include conventional toothbrushes, floss, super floss, interdental stimulators, toothpicks, interproximal brushes, and rubber tip stimulators to name a few These aids all work with varying degrees of success but are generally too bulky, too cumbersome, or virtually impossible to manipulate to effectively clean the lingual aspect (tongue side) of the abutment.
Several attempts have been made to provide toothbrushes and periodontal aids for use with the cleaning of implants. Unfortunately, all of these brushes are equipped with a conventional head, with a rectangular shape. The mouth and arches are formed in an ovoid shape, being rather constricted in the anterior regions of the jaw, especially on lingual surfaces. Whether there are teeth, bridges, or implants present in the front of the mouth, these conventional brush heads are oversized, poorly shaped and angled for effective use as periodontal aids.
Some brushes are bent at angles of approximately 20 to 30 degrees, similar to the angulation of dental mirrors. This angle does not permit effective cleaning because dental mirrors are angled for vision, not for cleaning ability. Further, the location of the bend in the brush, which is in the middle third of the brush, makes it inconvenient and uncomfortable to place a rectangular head behind the teeth without the handle being an obstacle.
One attempt to provide a device for implant cleaning is U.S. Pat. No. 4,941,227, issued to H. Sussman on Jul. 17, 1990. Sussman provides a horseshoe-shaped brush that is at a 90 degree angle from the handle. The horseshoe is open on the side of the brush away from the handle. This means that the opening is on the lingual side. However, the lingual surface is the hardest surface for patients to clean and the surface most neglected. This horseshoe-shaped brush would continue to neglect the lingual side. Further, the bristles surrounding the horseshoe wire are improperly aligned in relation to the brush. Because of its alignment, the circular shape of the bristles around the horseshoe wire would not fit into the angle created where the gums meet the teeth, bridges, and implants.
What is needed, then, is an all purpose device for effective dental hygiene with dental implants. This all purpose device must have a head that is properly sized and shaped to provide ready access to the lingual side of the implant posts as well as to the entire implant and posts. This cleaning device must be angled so that it can reach behind the lingual side of the implant post as well as the remaining sides of the implant. The device must provide dental hygiene for a periodontal patient The device must be flexible enough to provide for both effective cleaning of the lingual side of the implant posts as well as behind the implant and the implant posts. This device is presently lacking in the prior art.